Alzheimers disease

Advances in TCM Treatment of Senile Dementia


By Sun Guanlan, Ren Jianlin and Sun Qingjun

(Ningjin County Hospital of Traditional Chinese Medicine, Shandong Province 253400)

Senile dementia is a chronic progressive disease of mental deterioration. It corresponds to “idiocy", "melancholia" or "epilepsy" in TCM. The pathogeneses, and symptoms and signs of this disease are very complicated, which makes it all the more difficult to treat. In recent years, TCM has shown remarkable effects in treatment of this disease. A brief account of which is given as follows.

Treatment According to Analysis of Symptoms and Signs
TCM holds that although located in the brain, this disease is closely related to insufficiency of Qi of the Zang-Fu organs, and phlegm and blood stasis, on which a sound differentiation should be based.

l. Treatment based on differentiation of its types:
This disease is usually classified into two types, excess syndrome and deficiency syndrome, with the former due to excessive phlegm and blood stasis, while the latter to
deficiency of the liver spleen and kidney. 
Dr. Wang Hengsong divided the excess and deficiency syndromes of this disease further into six subtypes and treated it accordingly. The modified “Bu Shen Yi Sui Tang (Decoction for Tonifying the Kidney and Marrow)" was used for the syndrome of deficiency of the brain and spinal cord; the modified “Gui Pi Tang (Decoction for Invigorating the Spleen)" and “Yang Xin Tang (Decoction for Nourishing the Heart)" were used for the syndrome of deficiency of both the heart and spleen; the modified “Tianma Gouteng Yin (Decoction of Gastrodia and Uncaria)" and “Huanglian Xie Xin Tang (Decoction of Coptis for Reducing Heart-fire) were used for the syndrome of hyperactivity of the heat- and liver-fire; the modified “Qi Ju Dihuang Tang (Decoction of Rehmannia plus Wolfberry Fruit and Chrysanthemum )”and “Ding Zhi Tang (Decoction for Strengthening the Mind )" for the syndrome of Yin-deficiency of the liver and kidney; the modified “Banxia Baizhu Tianma Tang (Decoction of Pinellia, Bighead Atrctylodes and Gastrodia)" for the syndrome of stagnation and obstruction of phlegm and blood stasis; and the modified “Xiao Yao San (Ease Powder )"and “Tong Qiao Huo Xue Tang (Decoction for Activating Blood Circulation )"for the syndrome of stagnation of Qi and blood stasis. Dr. Zhou Kang treated differentially 60 such cases, which were divided also into 6 subtypes. The type of heart disorder was treated by nourishing the heart to calm the mind, with such drugs as Tianmaidong (Radix Ophiopogonis), Baihe (Bulbus Lilii), Shengdi (Radix Rehmanniae), Dangshen (Radix Codonpsis), Huangqi (Radix Astragali), and Baizhu (Rhizoma Atractylodis Macrocephalae). The type of hyperactivity of liver-Yang was treated by calming down the liver, with the following drugs of Shijueming (Concha Haliotidis), Gouteng (Ramulus Uncariae cum Uncis), Cishi (Magnehtum), Longgu (Os Draconis), Chuanxiong (Rhizoma Chuanxiong), and Gaoben (Rhizoma Ligustici). The type of stagnation of Qi was treated by regulating the flow of Qi to alleviate mental depression with drugs of Chaihu (Radix Bupleuri), Qingpi (Pericarpium Citri Reticu1atae Viride), Xiangfu (Rhizoma Cyperi), Muxiang (Radix Aucklandiae),Zhishi (Fructus Aurantii Immaturus), Yujin (Radix Curcumae), and Wuyao (Radix Linderae). The type of Yin-deficiency was treated by nourishing Yin to reduce pathogenic fire with drugs of Shihu (Herba Dendrobii), Shengdi (Radix Rehmanniae), Maidong (Radix Ophiopogonis), Yuanshen (Radix Scrophulariae), Wumei (Fructus Mume),and Wuweizi (Fructus Schisandra). The type of insufficiency of Yang was treated by warming Yang to tonify the kidney with drugs of Fuzi (Radix Aconiti Preparata), Ganjiang (Rhizoma Zingiberis), Rougui (Cortex Cinnamomi), Gancao (Radix Glycyrrhizae), Roucongrong (Herba Cistanchis), and Bajitian (Radix Morindae Officinalis). Cases with mild symptoms were treated by promoting blood circulation to remove blood stasis with drugs of Ezhu (Rhizoma Zedoariae), Chishao (Radix Paeoulae Rubra), and Dahuang (Radix et Rhizoma Rhei). 
Dr. Xu Jiezhong divided the disease into 5 subtypes based on differentiation of excess and deficiency syndrome. For the type of obstruction by phlegm, the modified “Er Chen Tang (Decoction Composed of Two Long-preserved Drugs)"was used; for the type of upward stirring of phlegm-heat, the modified “Wen Dan Tang (Decoction for Clearing Away Gallbladder-Heat )"was used; for the type of obstruction of collaterals in the brain due to interior retention of blood, the modified “Tao Hong Si Wu Tang (Decoction of Four Ingredients plus Peach Kernel and Salflower)"was used; for the type of malnutrition of the sea of marrow due to Yin-deficiency of the liver and kidney, the modifled “Zuo Gui Wan (The Kidney-Yin Nourishing Bolus)"was used; and for the type of malnutrition of the brain and the spinal cord due to insufficiency of the spleen and kidneyYang, the modifled “Gui Fu Li Zhong Tang (Decoction for the Reinforcing Middle-jiao with Cinnamon and Aconite )"or “Jin Gui Shen Qi Wan (Bolus for Strengthening the Kidney-Qi )"was used. 
Dr. Zhang Ziyi' offered 5 differential methods of treatment for the disease. The method of nourishing the kidney and brain and calming down the mind was adopted, using the self made “Bu Nao Yang Shen Tang (Decoction for Nourishing the Brain and Calming the Mind)" the method of tonifying the kidney, replenishing essence and nourishing the brain was adopted with the self made modified “Er Xian Tang (Modified Decoction of Two Wonder Drugs )" the method of nourishing the heart and calming the mind was adopted with the modified “Gui Pi Tang (Decoction for Invigorating the Spleen and Nourishing the Heart )" the method of relieving depression by removing phlegm for resuscitation was adopted with the self made “Si Er Xuan Qiao Tang (Decoction for Resuscitation)" and the method of promoting the circulation of Qi and blood for resuscitation was adopted with the modified “Bu Yang Huan Wu Tang (Decoction of Invigorating Yang for Resuscitation)" 
The disease was differentiated by Dr. Fu Renjie, et al, into the following 4 types. The type of flaring up of the heart-fire and interior disturbance by phlegm-heat was treated by clearing away fire and eliminating phlegm for resuscitation with drugs of Huanglian (Rhizoma Coptidis), Zhizi (Fructus Gardeniae), Shengdi (Radix Rehmanniae), Zhuru (Caulis Bambusae in Taeniam), Yuanshen (Radix Scrophulariae), Maidong (Radix Ophiopogonis), and Huangqin (Radix Scutellariae). The type of Yin-deficiency of the liver and kidney and hyperactivity of the liver-Yang was treated by nourishing Yin, suppressing hyperactive Yang and calming down the liver-fire for resuscitation with drugs of Shengdi (Radix Rehmanniae), Juemingzi (Semen Cassiae), Tianma(Rhizoma Gastrodiae), Gouteng (Ramulus Uncariae cum Uncis), Baishao (Radix Paeoniae Alba), Yuanshen (Radix Scrophuleriae), Chuanlianzi (Fructus Toosendan), and Longgu (Os Draconis) Muli (Concha Ostreae). The type of insufficiency of Qi and blood stasis was treated by promoting the circulation of Qi to remove blood stasis with drugs of Huangqi (Radix Astragali), Dangshen (Radix Codonopsis), Renshen (Radix Ginseng), Danshen (Radix Salviae Miltiorrhizae), Chishao (Radix Paeoniae Ruba), Danggui (Radix Angelicae Sinensis), and Chuangxiong (Rhizoma Chuanxiong). And the type of insufficiency of the sea of marrow was treated by nourishing the kidney and marrow, enlivening the spleen and benefiting the brain with drugs of Gouqizi (Fructus Lycii), Shanyurou (Fructus Corni), Shudi (Radix Rehmanniae Praeparata), Heshouwu (Radix Polygoni Multiflori), Tusizi (Semen Cuscutae), Fushen (Poria cum Ligno Hospite), Bajitian (Radix Morindae Officinalis), and Shichangpu (Rhizoma Acori Tatarinowii). 
Dr. Xu Shizhen divided this disease into the following 4 types. The type of Yin-deficiency of the liver and kidney was treated with the modified “Bu Shen Yi Nao Tang (Decoction for Nourishing the kidney and Brain). The type of insufficiency of Yang of the spleen and kidney was treated with the modified “You Gui Wan (The Kidney-Yang Reinforcing). The type of accumulation and obstruction of phlegm was treated with the modified “Er ChenTang (Two Old drugs Decoction)" And the type of interior obstruction of blood stasis was treated with the modified “Fu Yuan Huo Xue Tang (Decoction for Recovery and Activating Blood Circulation). Dr. Zhao Xiangjun, in regard to insufficiency of the sea of marrow treated the type of failure of the kidney-essence with the modified “You Gui Wan (The Kidney-Yang Reinforcing Bolus)" The type of Yin-deficiency of the liver and kidney with Zuo Gui Wan (The Kidney-Yin Nourishing Bolus)" the type of deficiency of both the heart and spleen with “Gui Pi Tang (Decoction for Invigorating the Spleen and Nourishing the Heart)" and the type of obstruction of phlegm and blood stasis with “Meng Shi Gun Tan Wan (Bolus of Chlorite-Schist for Expelling Phlegm)"and “Xuefu Zhu Yu Tang (Decoction for Removing Blood Stasis in the Chest )"
2. Treatment by regulating and nourishing the heart and kidney:
Dr. Lin Changting, et al. treated the disease by regulating the heart and nourishing the kidney. Cases of insufficiency of the heart Qi were treated with the prescription for regulating the heart, consisting of drugs of Dangshen (Radix Codonopsis), Fuling
(Poria), Gancao (Radix Glyc~zae), Shichangpu (Rhizoma Acori Tatarinowii), and
Yuanzhi (Radix Polygalae). Cases of deficiency and failure of the kidney-Yin were
treated with the prescription for tonifying the kidney consisting of drugs of Tiandong (Radix Asparagi), Maidong (Radix Ophiopogonis), Shengdi (Radix Rehmanniae), Shudi (Radix Rehmanniae Preparata), and Shanyurou (Fructus Corni). Altogether 80 cases were thus treated with the result turning out to be that ll cases cured, 23 markedly effective, 25 effective, and 2l ineffective. 
Dr. Yao Peifa adopted 4 methods of treatment based on the differentiation of deficiency of the kidney, phlegm and blood stasis. 
l) Reinforcing the kidney and replenishing essence with drugs of Shudi (Radix Rehmanniae Praeparata), Gouqizi (Fructus Lycii), Heshouwu (Radix Polygoni Multiflori), Xianmao (Rhizoma Curculiginis), Xianlingpi (Herba Epimedii), Changpu (Rhizoma Acori Tatarinowii); and Yuanzhi (Radix Polygalae); 
2) Nourishing the kidney and eliminating phlegm for resuscitation by using the modified “Ding Zhi Wan (Bolus for the Mind)"and “You Gui Wan (The Kidney-Yang Reinforcing Bolus ); 
3) Nourishing the kidney, and removing blood stasis for resuscitation with materials of Shudi (Radix Rehmanniae Preparata), Heshouwu (Radix Polygoni Multiflori), Gouqizi (Fructus Lycii), (Chuan) Niuxi (Radix Cyathulae), Taoren (Semen Persicae), Honghua (Flos Carthami), Chuanxiong (Rhizoma Chuxiong), Dilong (Pheretima), Xiangfu (Rhizoma Cyperi), Changpu (Rhizoma Acori Tatarinowii), and Yuanzhi (Radix Polygalae); and 
4) Nourishing Yin and eliminating phlegm, using such materials as Shudi (Radix Rehmanniae Praeparata), Heshouwu (Radix Polygoni Multiflori), Maidong (Radix Ophiopogonis), Lianqiao (Fructus Forsytheae), Zhuli (Succus Bambusae), Huanglian (Rhizoma Coptidis), (Qing) Banxia (Rhizoma Pinelliae), Yujin (Radix Curcum), Changpu (Rhizoma Acori Tatarinowii), Yuanzhi (Radix Polygalae) and Danshen (Radix Salviae Miltiorrhizae).  
3. Treatment based on differentiation of the symptoms of blood stasis and phlegm:
Dr.Yan Qianlin divided the disease into 4 types and treated them mainly by removing blood stasis and phlegm. For obstruction of phlegm and blood stasis, the modified “Huanglian Wen Dan Tang (Decoction of Coptis for Clearing Heat of Gallbladder)" and “Tong Qiao Huo Xue Tang (Decoction for Activating Blood Circulation for Resuscitation ) were prescribed. For stagnation of Qi and blood stasis, the modified “Dian Kuang Meng Xing Tang (Decoction for Manic-Depressive Psychosis) was given. For insufficiency of Qi and blood stasis, the modified “Yi Qi Cong Ming Tang (Decoction for Reinforcing Qi and Nourishing the Brain ) and Tao Hong Si Wu Tang (Decoction of Four Ingredients plus Peach Kernel and Salflower) were administered. And for emptiness of the sea of marrow and blood stasis, “Xing Nao Yi Zhi Tang (Decoction for Restoring Resuscitation and Refreshing the Mind) was used. Based on the theory that phlegm leads to idiocy, 
Dr. Zhang Jueren treated the disease aiming at eliminating phlegm. For the type of upward attack of wind-phlegm leading to obstruction in the brain, “Banxia Baizhu Tianma Tang (Decoction of Pinllia, Bighead Atractylodes and Gastrodia), together with “Changpu Yujin Tang (Decoction of Acori Tatarinowii and Curcumae)" were used. For the type of mental cloudiness due to phlegm preventing the lucid Yang to rise, the above “Banxia Baizhu Tianma Tang"was used with Shichangpu (Rhizoma Acori Tatarinowii) in heavy dose, and with Gaoben (Rhizoma Ligustici) and Baizhi (Radix Angellcae Dahuricae) added to induce the resuscitation. For the prolonged cases with phlegm and blood stasis getting into the collaterals, the above prescripton was used in combination with the modified “Bu Yang Huan Wu Tang (Decoction Invigorating Yang for Resuscitation)" For the type of phlegm due to deficiency, the modified “Banxia Tianma Tang Decoction of Pinellla and Gastrodia )"together with the modified “Changpu Yujin Tang (Decoction of Acori Tatarinowii and Curcumae)"were used to strengthen the body resistance, in which Roucongrong (Herba Cistanchis) and Hetaorou (Semen Juglandis) were given in heavy dose.

Treatment by Specific Prescriptions
1. Supplementing Qi and activating blood circulation to remove blood stasis:
This method exhibits the functions of improving microcirculation of the brain, increasing the volume of blood flow and promoting metabolism of the brain. 
Dr. Wang Qiudong, et al. developed the method of replenishing Qi and removing blood stasis, with the prescription consisting of Huangqi (Radix Astragali), Chuanxiong (Rhizoma Chuanxiong), Chishao (Radix Paeoniae Rubra), Baishao (Radix Paeoniae Alba), Taoren (Semen Persicae), Gegen (Radix Puerariae), Jixueteng (Caulis Spatholobi), Dangshen (Radix Codonopsis), Changpu (Rhizoma Acori Tatarinowii), Yujin (Radix Curcumae), Yizhiren (Fructus Alpiniae Oxyphyllae), and Yuanzhi (Radix Polygalae). 7 cases were thus treated, with marked effect shown in 4 cases, improvement in 2 cases, and no effect in one case.
2. Nourishing the kidney and brain:
This is a cornmonly-used method for senile dementia. 
Dr. Shang Zhichang, et al. used the modified “Dihuang Yin Zi (Rehmanniae Decoction) in l84 cases of the disease due to insufficiency of the sea of marrow; of them, l4 were markedly effective, 90 improved, and 20 cases ineffective, the total effective rate being 89.l3%. 
Dr Yuan Yingjian employed self-made “Bu Shen Yi Nao Tang (Decoction for Nourishing the Kidney and Brain)" consisting of Heshouwu (Radix Polygoni Multiflori), Shanyurou (Fructus Corni), Shanyao (Rhizoma Dioscoreae), Gouqizi (Fructus Lycii), Tusizi (Semen Cuscutae), Chishao (Radix Paeoniae Rubra), Danshen (Radix Salviae Miltiorrhizae), and Yujin (Radix Curcumae). In the 20 cases treated, with marked effect shown in l3, effect in 6, and no effect in one, with a total effective rate of 95%.
3. Tonifying the kidney, supplementing Qi and activating blood circulation:
Dr.. Zhai Xiuling, et al. employed “Bu Shen Yi Qi Huo Xue Tang (Decoction for Tonifying the kidney, Supplementing Qi and Activating Blood Circulation) as the basic prescription for cases of deficiency of the kidney and blood stasis, which contains drugs of Huangqi (Radix Astragali), Dangshen (Radix Codonopsis), Gegen (Radix Puerariae), Danshen (Radix Salviae Miltiorrhizae), Shanzha (Fructus Crataegi), Gouqizi (Fructus Lycii), Huangjing (Rhizoma Polygonati), Shanyurou (Fructus Corni),
Danggui (Radx Angelicae Sinensis), Tianma (Rhizoma Gastrodiae), and Shichangpu
(Rhizoma Acori Tatarinowii); for cases of excessive fire in the heart and liver added
“Huanglian Jie Du Tang (Antidotal Decoction of Coptis) to the above basic prescription; for cases of Yin-deficiency of the liver and kidney “Yi Guan Jian (An Ever Effective Decoction for Nourishing the Liver and Kidney)"was added; for cases with obstruction of phlegm in the brain, “Dao Tan Tang (Decoction for Expelling Phlegm)"was added; and for cases with insufficiency of Qi and blood stasis, Chuanxiong (Rhizoma Chuanxiong), Chishao (Radix Paeoniae Rubra), and Quanxie (Scorpio) were added to the basic prescription. 23 cases of dementia due to cerebrovascu1ar disorder were thus treated. Of them, 9 cases were cured, l2 effective, and 2 ineffective, with a total effective rate of 91.3%. 
Dr. Hong Shuyun used self made “Yi Zhi Huo Xue Tang (Decoction for Refresning the Mind and Activating Blood Circulation), consisting of Huangqi (Radix Astragali), Danshen (Radix Salviae Miltiorrhizae), Dangshen (Radix Codonopsis), Yizhiren (Fructus Alpiniae Oxyphyllae), Shichangpu (Rhizoma Acori Tatarinowii), Gouqizi (Fructus Lycii), Heshouwu (Radix Polygoni Multflori), Yuanzhi (Radix Polygalae), Chishao (Radix Paeoniae Rubra), and Chuanxiong (Rhizoma Chuanxiong). 2l cases were thus treated, with marked effect shown in 4, effect in 10, no effect in 7. The total effective rate was 66.7%.
4. Tonifying the kidney and activating blood circulation to remove blood stasis:
Dr. Li Weihua treated 48 cases with self-developed “Yi Shen Hua Yu Jiang Zhuo
Tang (Decoction for Nourishing the Kidney, Eliminating Blood Stasis and Dispelling
Phlegm)"which is made from Shanyurou (Fructus Corni), Tusizi (Semen Cuscutae), Yizhiren (Fructus Alpiniae Oxyphyllae), Yujin (Radix Curcumae), Dannanxing (Arisaema cum Bile), Yuanzhi (Radix Polygalae), Shichangpu (Rhizoma Acori Tatarinowii), Ziheche (P1acenta Hondnis), Shuizhi (Hirudo), and Shanzha (Fructus Crataegi). Of the 48 cases thus treated, 2l had remarkable effect, 23 effect, and 4 no effect. The total effective rate was 9l.6%. 
Dr. Sun Jiming treated l2 cases using self- made “Yi Shen Huo Tan Tang (Decoction for Nourishing the Kidney and Eliminating Phlegm for Resuscitation)" which contains Shudi (Radix Rehmanniae Preparata), Roucongrong (Herba Cistanchis), (Zhi) Guiban (Plastrum Testudinis Preparata), Shanyurou (Fructus Corni), Huangjing (Rhizoma Polygonati), Yujin (Radx Curcumae), Baijili (Fructus Tribuli), Jiangcan (Bombyx Batryticatus), Tianma (Rhizoma Gastrodiae), Huangqi (Radix Astragali seu Hedysed), Shichangpu (Rhizoma Acori Tatarinowii), (Zhi) Nanxing (Arisaema cum Bile Praeparata), and Honghua (Flos Carthami). Of the l2 cases thus symptomatologically treated, 3 showed marked effect, 8 effect, and l no effect.
5. Dispelling phlegm and removing blood stasis:
Dr.Du Xi treated 38 cases with self-made “Di Tan Hua Yu Tang (Decoction for Dispelling Phlegm and Removing Blood Stasis)"i.e. “Wen Dan Tong (Decoction for Reducing Heat of Gallbladder)"adde with Shichangpu (Rhizoma Acori Tatarinowii), Yujin (Radix Curcumae), Jiangcan (Bombyx Batryticatus), Dannanxing (Arisaema cum Bile), Tianma (Rhizoma Gastrodiae), and Danshen (Radix Salviae Miltiorrhizae). Of the 38 cases thus treated, 1l showed marked effect, l3 improvement and l4 no effect. Dr. Yue Jianping, employed the self-made “Di Tan Hua Yu Tong Luo Tang (Decoction for Dispelling Phlegm and Promoting Blood Circulation by Removing Blood Stasis)"as the basic prescription, which consists of Huangqi (Radix Astragali), Chishao (Radix Paeoaiae Rubra), Chuanxiong (Rhizoma Chuanxiong), Taoren (Semen Persicae), Dilong (Pheretima), Yujin (Radix Curcuma), Shichangpu (Rhizoma Acori Tatarinowii), Yuanzhi (Radix polygalae), Zhuru (Caulis Bambusae in Taeniam), Juhong (Exocarpium Citri Rubrum), (Qing) Banxia (Rhizoma Pinelliae), Honghua (Flos Carthami), Tianma (Rhizoma Gastrodiae), Jiangcan (Bombyx Batyticatus), Quanxie (Scorpio), Shuizhi (Hirudo), and Wugong (Scolopendra). Of the 20 cases treated as above, 1l showed marked effect, 7 effect, and 2 no effect. 
Dr.Yang Wenjin, et al, treated 3l cases of dementia due to cerebrovascular disorders with the modified “Jie Yu Dan (Dysphasia Pills)" l8 of them were cured, and l1 improved, with a total effective rate of 93.55%.

Acupuncture and Other Therapies
Acupuncture can produce the effect of promoting circulation of Qi and blood by removing obstructions in meridians and collaterals and regulating Yin and Yang of the
Zang-Fu organs, hence it has a very good effect in treating senile dementia cases with "sticky, thick and static" blood. 
Dr. Shen Weidong, et al. treated 40 cases of this type by acupuncture at points Hegu (LI 4), Shenmen (HT 7), Jianshi (PC 5), Zusanli (ST 36), Sanyinjiao (SP 6), Taichong (LR 3), and Shenting (GV 24). For cases with irritability and stirring up of fire, Fengchi (GB 20) and Taixi (KI 3) were added; for cases of slobbering, Dicang (ST 4) and Jiache (ST 6) were added; for dysphasia, Lianquan (CV 23) was added; for chest distress and palpitation, Neiguan (PC 6) was added; and for dysuria, Guanyuan (CV 4) and Zhongii (CV 3) were added. Of the 40 cases treated with the above prescription, 10 had marked effect, 24 effect, and 6 no effect. 
Dr. Zhan Anren, et al. selected only Houxi (SI 3) and Shenmen (HT 7) for the treatment. After obtaining needling sensation, the needles were retained for 30 minutes during which the needles were manipulated by the uniform reinforcing-reducing method once every 5 minutes. All the 32 cases treated, showed improvement in cognitive ability. 
Dr.Wang Zhuxing selected Baihui (GV 20), Shenting (GV 24), Fengchi (GB 20), Jianshi (PC 5), Shuigou (GV 26), and Sishencong (EX-HN1) for the treatment. For dizziness and headache, Taiyang (EX-HN5), Hegu (LI 4) and Taichong (LR 3) were added; for mania, Shixuan (EX-HN13), Taichong (LR 3) and Yanglingquan (GB 34) were added; for depression, Neiguan (PC 6), Fenglong (ST 40), and Yintang (EX-HN13) were added; for insomnia, Shenmen (HT 7) and Neiguan (PC 6) were added. The above points were needled by the reducing method, and acupuncture was combined with herbal medicine. l60 cases were treated as above, with complete recovery shown in 5l, marked effect in 76, improvement in l8, and no effect in l5. The total effective rate was 90.6%. 
Dr. Xie Yongyong used intravenous drip with 20 ml Salvia Injection added to 250 ml of 5% glucose. The treatment was given once daily and 30 days constituted one therapeutic course. l5 cases were thus treated, showing remarkable effect in all.

Comments
TCM holds that while the location of the disease is in the brain, its root cause is insufficiency of vital essence and energy of various Zang-Fu organs in addition to
obstruction by stagnation of phlegm and blood stasis. The weak constitution due to old age often leads to weakness and failure of the Zang-Fu organs and deficiency of Qi and blood, and deficiency of Yin and Yang. This weakness and failure may give rise to stagnation of Qi, causing blood stasis, which, in turn, leads to accumulation of Qi to form phlegm that may retain in the five Zang organs and obstruct collaterals of the brain to confuse the mind, hence occurrence of dementia. Its pathogenesis is deficiency in origin and excess in superficiality. Therefore, treatment should aim at both deficiency in origin, i.e. deficiency of Qi and blood, and excess in superficiality i.e. obstruction of phlegm in the heart. However in whatever the case, the principle of removing obstruction and promoting Qi and blood circulation for resuscitation and normal mental activity should be abided by in this respect, TCM treatment is superior in producing its unique effect.
  

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